Community health workers’ knowledge, attitudes, and practices towards epilepsy in Sofala, central Mozambique

Abstract: Background: Epilepsy is the most common neurological disease in the world, affecting 50 million people, with the majority living in low- and middle-income countries (LMICs). A major focus of epilepsy treatment in LMICs has been task-sharing the identification and care for epilepsy by commu...

Descripción completa

Detalles Bibliográficos
Autores: Cumbe, Vasco Francisco Japissane [UNIFESP], Greene, Claire, Fumo, Afonso Mazine Tiago, Fumo, Hélder, Mabunda, Dirceu [UNIFESP], Gouveia, Lídia Chaúque [UNIFESP], Oquendo, Maria A., Duarte, Cristiane S., Sidat, Mohsin, Mari, Jair de Jesus[UNIFESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/65988
Acceso en línea:https://www.mdpi.com/1660-4601/19/22/15420
https://doi.org/10.3390/ijerph192215420
https://repositorio.unifesp.br/handle/11600/65988
Access Level:acceso abierto
Palabra clave:Epilepsy
Community health workers
Knowledge
Attitudes
Practices
Primary health care
Mozambique
Descripción
Sumario:Abstract: Background: Epilepsy is the most common neurological disease in the world, affecting 50 million people, with the majority living in low- and middle-income countries (LMICs). A major focus of epilepsy treatment in LMICs has been task-sharing the identification and care for epilepsy by community health workers (CHWs). The present study aimed to assess the knowledge, attitudes, and practices (KAPs) of CHWs towards epilepsy in Mozambique. Methods: One hundred and thirty-five CHWs completed a questionnaire that included socio-demographic characteristics and 44-items divided into six subscales pertaining to KAPs towards epilepsy (QKAP-EPI) across nine districts of Sofala, Mozambique. The internal consistency was examined to evaluate the reliability of the instrument (QKAP-EPI). The association between sociodemographic variables and QKAP-EPI subscales was examined using linear regression models. Results: The internal consistency was moderate for two subscales (causes of epilepsy, α = 0.65; medical treatment, α = 0.694), acceptable for cultural treatment (α = 0.797) and excellent for 2 subscales (safety and risks, α = 0.926; negative attitudes, α = 0.904). Overall, CHWs demonstrated accurate epilepsy knowledge (medical treatment: mean = 1.63, SD = 0.28; safety/risks: mean = 1.62, SD = 0.59). However, CHWs reported inaccurate epilepsy knowledge of the causes, negative attitudes, as well as culturally specific treatments for epilepsy, such as: “if a person with epilepsy burns when set on fire they cannot be treated”. Knowl- edge about how to manage epileptic seizures varied across the different emergency care practices, from the accurate belief that it is not advisable to place objects in the individual’s mouth during an epileptic seizure, to the wrong perception of the need to hold the person in seizures to control seizures. Heterogeneity in the level of epilepsy knowledge was observed among CHWs, when consid- ering epilepsy according to the local names as treatable (“Dzumba”) and other forms as untreatable (“Nzwiti”). Conclusion: CHWs knowledge of medical treatment and epilepsy safety/risks were adequate. However, information on the causes of epilepsy, stigmatizing attitudes, cultural treatment, and some knowledge of epileptic seizure management were low. These areas of poor knowledge should be the focus of educating CHWs in increasing their ability to provide quality care for patients with epilepsy in Mozambique.